Organization
WILLIAM A. OLIVOS, OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM A OLIVOS OD (OWNER/PRESIDENT)
(772) 460-8487
Entity
Organization
Contact information
Practice address
4976 S 25TH ST, FORT PIERCE, FL 34981-4923
(772) 460-8487
(772) 460-0225
Mailing address
4976 S 25TH ST, FORT PIERCE, FL 34981-5009
(772) 460-8487
(772) 460-0225
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
OPC 3500
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5718990001
PALMETTO- DMERC
FL
05
—
620569100
—
FL
Enumeration date
09/20/2006
Last updated
07/29/2015
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